Biomedical subjects

L Mailhan

Publications and source records attributed to L Mailhan.

6 recordsLinked to original sources

PubMed2006

[Strength, postural and gait changes following rehabilitation in multiple sclerosis: a preliminary study].

OBJECTIVE: To evaluate the impact of rehabilitation on balance, gait and strength in inpatients with multiple sclerosis (MS). METHODS: Twenty-one in patients with MS benefited from a program of rehabilitation with evaluation before and after rehabilitation. Balance was assessed by stabilometry, walking speed with use of a locometer device and maximal peak torque of knee extensor and flexor with use of an isokinetic dynamometer at 60 degrees /s speed. The functional independence measure (FIM) was also applied before and after rehabilitation. RESULTS: After rehabilitation, patients showed significant improvement in balance with opened and closed eyes, velocity gait, strength of the lower quadriceps and the higher hamstrings and FIM values. Absolute values of gait speed and strength parameters were related as were improvement in velocity speed and the higher hamstrings. CONCLUSION: The results are encouraging and confirm the interest and tolerance of a program of rehabilitation among patients with MS.

Adult↗

PubMed2006

Intrathecal baclofen for treatment of spasticity of multiple sclerosis patients.

We conducted a retrospective study of the case files of 64 multiple sclerosis (MS) patients presenting severe spasticity, who had received intrathecal (IT) baclofen test injections between 1992 and 2004 in a rehabilitation unit. In almost all cases of our series, IT baclofen was proposed to patients who were no longer able to walk. IT baclofen is a safe and effective treatment to reduce spasticity in MS patients. Despite an advanced stage of the disease at the time of pump placement, the complication rate was low and the efficacy of this treatment was maintained over time.

Adult↗

PubMed2003

[Surgical treatment of orthopedic deformities due to spasticity in the lower limb].

Orthopedic deformities in the lower limb concern all joints (hip, knee, ankle, foot) with a wide range of clinical forms. Spasticity, contracture, stiffness, laxity, neurological deficit are assessed to establish the surgical procedure. Surgical techniques are adapted to the goals that are detailed with the patient and his family: standing, transferring, walking, hygiene, devices (shoes, orthosis, canes, wheelchair). Surgical procedures can associate: lengthening of contractured muscles (tenotomy with or without sutures, fractional lengthening at the musculo-tendinous junction or desinsertion), strengthening of antagonists (passive or active tendon transfer) and correction of joint deformity (arthrolysis, arthrodesis, arthroplasty). In adults, the most common deformities are the equinus or equinovarus foot, toe curling, hip adductum, knee flessum. Talus or knee recurvatum are less frequently observed. The association of various deformities raises questions concerning the hierarchy of surgical procedure, from an anatomical point of view (do we start with proximal or distal joint first?) as from chronological concerns (shall we do one or more procedures?). Pluridisciplinary assessment using neurological anesthetic blocs and dynamic EMG or gait analysis is necessary to detail the aims of surgery and choose the surgical procedures.

Foot Deformities, Congenital↗

PubMed2002

[Double dissociation between unilateral neglect and anosognosia].

We report two patients presenting with a subacute right hemisphere stroke. These cases demonstrate a double dissociation between unilateral neglect and anosognosia for hemiplegia. The first patient suffered from a severe left hemiplegia associated with severe and persisting unilateral neglect. He appeared fully aware of his motor impairment. The second patient had a severe left hemiplegia, without any major sign of unilateral neglect on clinical tests nor on behavioural assessment. Nevertheless, he presented a severe and sustained anosognosia for hemiplegia. These case reports support the assumption that anosognosia and unilateral neglect, although they are frequently associated, may rely on independent mechanisms.

Aged↗

PubMed2001

[Spasticity and multiple sclerosis].

Spasticity is a common symptom in MS patients. It is easy to recognize and evaluate spasticity at rest. The efficacy of numerous treatments has been well documented. Nevertheless, it is difficult, particularly in MS patients, to assess the functional disability due to spasticity and the functional benefit due to treatment. This is why it is appears more appropriate to use therapeutic tests with transitory effects such as anesthetic blocks in case of focal spasticity or intrathetical baclofen in case of diffuse spasticity. It is also possible to use reversible treatments such as botulinum toxin injections before proposing section of a peripheral nerve.

Disability Evaluation↗

PubMed2001

[Conduction aphasia and phonemic disorder].

Conduction aphasia is usually described as a repetition impairment. Semiology or pathophysiology cannot be explained with this definition. We report a single case particularly demonstrative. The patient showed spontaneous speech, denomination, repetition and reading impairments. Main errors were phonemic paraphasia. No arthric disorder nor comprehension impairment was observed. Damage of supramarginalis gyrus and Wernicke's area was found. A cognitive analysis suggested that the phonological buffer and the working memory were impaired. Implication for rehabilitation, which included segmentation and semantisation associated to phonological training, is discussed. The course of the conduction aphasia was good and the patient was able to work again.

Aphasia, Conduction↗